Involuntary leakage of urine is very common in women. There are several types of incontinence, but the most common among women is called stress incontinence, which refers to loss of urine when straining (e.g., laughing, coughing, sneezing, etc.). In the United States, more than 11 million women are affected by stress incontinence. Urge incontinence is usually an uncontrollable urge to go to the bathroom, that is often followed by leakage of urine before the toilet is reached. Medications are used to treat urge incontinence. Mixed incontinence is a combination of these two types.

Left untreated, urinary incontinence can progress to the point that it becomes socially embarrassing, and has been cited as the most common reason for families to place their grandmothers in nursing homes.

Diagnosis:
Treatment for urinary incontinence varies according to the type of incontinence. The first step in treatment is accurate diagnosis. This consists of the patient’s medical and urological history, physical and pelvic examination, and some simple office tests, such as post void residual urine (the amount of urine left in the bladder after voiding), the Q-Tip test (which tells how mobile the urethra is, and if there is an anatomic component to the incontinence). Additional tests may be necessary in more complicated cases.

Urodynamic Measurement System:

Advanced Technology, Simplified Diagnosis

The GYNECARE® MoniTorr is the first and only diagnostic tool designed to measure URP (Urethral Retro-resistance Pressure). URP offers a new way to evaluate female urethral function:

The GYNECARE® MoniTorr uses a plug that is held against the urethral meatus and enters no more than ¼ inch. It also offers Single Channel Cystometrogram (CMG) to assist in the diagnosis of Urge Incontinence and Leak Point Pressure (LPP) assists in the diagnosis of Stress Incontinence

Past and Present:
The retropubic urethral suspension was introduced in 1910, and since then over 200 different surgical procedures for treating stress incontinence have been described. These procedures are designed to restore the bladder neck and urethra to their anatomically correct positions in patients with stress incontinence. The traditional Burch colposuspension, first described in 1961, has been considered the Gold Standard procedure. It is associated with long-term success rates ranging from 75-90%. Today, emphasizing the principles of minimally invasive surgery, laparoscopy has evolved as an alternative technique in the treatment of genuine stress incontinence. The Laparoscopic Burch involves placing permanent suture material adjacent to the neck of the bladder on each side and attaching them to a strong ligament (Cooper’s ligament) attached to the pelvic bone. The reported advantages include improved visualization of the retro-pubic anatomy, minimal blood loss, shorter hospitalization, and faster recovery.

Great strides have been made in the past decade in treating female urinary incontinence. The GYNECARE® TVT tension-free support for incontinence is a better and more effective way to improve the quality of life for women with urinary incontinence. To date, more than 500,000 procedures using the GYNECARE® TVT system have been carried out around the world, with a relatively low complication rate. Studies show a cure rate of 89% overall, with an improvement in an additional 5% of patients.

Procedure Choice:
Once diagnosed, stress incontinence is treated by surgery. The GYNECARE® TVT device is intended to be used as a pubourethral sling for the treatment of female stress urinary incontinence resulting from childbirth, causing urethral hypermobility. It also treats intrinsic sphincter deficiency (ISD).

What To Expect:
You may be able to go home as early as a few hours after your procedure, and return to a relatively normal schedule of activities the next day. We advise you to avoid heavy lifting and intercourse for four to six weeks.

In time, most patients will be able to return to the simple pleasures in life, laughing without risk of embarrassment of loss of urine.